Replication of Recovery and Reunification Interventions forFamilies-Impact Study (R3-Impact)

Forms and Documents

Document Name	Status
Supporting Statement A - R3-Impact 08.09.2023.docx Supporting Statement A	2023-08-10
Appx.E_Crosswalk of Topic Guides to Research Questions.docx Supplementary Document	2023-08-10
Appx.D_Crosswalk of Survey Items to Research Questions.docx Supplementary Document	2023-08-10
Appx.C_Informed Consent Form - Parent Interview.docx Supplementary Document	2023-08-10
Appx.B_Informed Consent Form - Impact Evaluation.docx Supplementary Document	2023-08-10
Appendix A_Text from SUPPORT Act Section C. 8082.docx Supplementary Document	2023-08-10
Supporting Statement B - R3-Impact 08.09.2023.docx Supporting Statement B	2023-08-10

IC Document Collections

IC ID	Document Title	Status
261538	Participant Interview Information Form Other-Information Form	New
261537	Topic Guide – Parents Other-Topic Guide	New
261536	Topic Guide – Parent/Family Mentors Other-Topic Guide	New
261535	Topic Guide – Mentor Supervisors Other-Topic Guide	New
261533	Topic Guide – Program Managers Other-Topic Guide	New
261531	Topic Guide – Partners Other-Topic Guide	New
261529	Topic Guide – Child Welfare Frontline Staff Other-Topic Guide	New
261522	Topic Guide – Child Welfare Lead Staff Other-Topic Guide	New
261521	Validation Interview Script Other-Interview Script	New
261520	Contact Form Other-Contact Form	New
261519	Baseline Parent Survey Other-Survey	New

ICR Details

OMB Control No:	ICR Reference No: 202308-0970-005
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Replication of Recovery and Reunification Interventions forFamilies-Impact Study (R3-Impact)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/14/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	3,626	0
Time Burden (Hours)	1,294	0
Cost Burden (Dollars)	0	0

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Abstract: The Replication of Recovery and Reunification Interventions for Families-Impact Study (R3-Impact) is a large multi-site study that will provide evidence about the effectiveness of two programs that use recovery coaches and what it takes to implement them in multiple settings with diverse populations. Data collection for the R3-Impact study under this information collection request includes (1) a parent survey measuring parent well-being at study enrollment, (2) quarterly contact forms to update participant contact information, (3) in-person and phone interview topic guides for site staff involved in program referral and implementation, (4) in-person and phone interview topic guide for parents participating in the study, and (5) a participant interview information form for parents interviewed.

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Authorizing Statute(s): PL: Pub.L. 115 - 271 C. 8082 Name of Law: 2018 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Pat
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 37067	06/06/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 55050	08/14/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 11

IC Title	Form No.	Form Name
Baseline Parent Survey
Contact Form
Participant Interview Information Form
Topic Guide – Child Welfare Frontline Staff
Topic Guide – Child Welfare Lead Staff
Topic Guide – Mentor Supervisors
Topic Guide – Parent/Family Mentors
Topic Guide – Parents
Topic Guide – Partners
Topic Guide – Program Managers
Validation Interview Script

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,626	0	0	3,474	152	0
Annual Time Burden (Hours)	1,294	0	0	1,207	87	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection request.

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Annual Cost to Federal Government: $1,491,468

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/14/2023

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